A Biomechanical Comparison of Fiberglass Casts and 3-Dimensional-Printed, Open-Latticed, Ventilated Casts

Hand (N Y). 2020 Nov;15(6):842-849. doi: 10.1177/1558944719831341. Epub 2019 Feb 27.

Abstract

Background: The aim of this study was to quantify the stabilizing properties of a 3-dimensional (3D)-printed short-arm cast and compare those properties with traditional fiberglass casts in a cadaveric subacute distal radius fracture model. Methods: A cadaveric subacute fracture model was created in 8 pairs of forearms. The specimens were equally allocated to a fiberglass cast or 3D-printed cast group. All specimens were subjected to 3 biomechanical testing modalities simulating daily life use: flexion and extension of digits, pronation and supination of the hand, and 3-point bending. Between each loading modality, radiological evaluation of the specimens was performed to evaluate possible interval displacement. Interfragmentary motion was quantified using a 3D motion-tracking system. Results: Radiographic assessment did not reveal statistically significant differences in radiographic parameters between the 2 groups before and after biomechanical testing. A statistically significant difference in interfragmentary motion was calculated with the 3-point bending test, with a mean difference of 0.44 (±0.48) mm of motion. Conclusions: A statistically significant difference in interfragmentary motion between the 2 casting groups was only identified in 3-point bending. However, the clinical relevance of this motion remains unclear as the absolute motion is less than 1 mm. The results of this study show noninferiority of the 3D-printed casts compared with the traditional fiberglass casts in immobilizing a subacute distal radius fracture model. These results support the execution of a prospective randomized clinical trial comparing both casting techniques.

Keywords: 3D printing; additive manufacturing; biomechanics; distal radius; fracture cast.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Cadaver
  • Casts, Surgical / classification*
  • Female
  • Forearm Injuries / physiopathology
  • Forearm Injuries / therapy
  • Humans
  • Male
  • Middle Aged
  • Printing, Three-Dimensional*
  • Prospective Studies
  • Radius Fractures / physiopathology
  • Radius Fractures / therapy*
  • Range of Motion, Articular